Evaluation for optimal dosing of vancomycin in patients with different physical types

Mari Hashimoto, Osamu Iketani, Naoki Ichinose, Yuki Enoki, Kazuaki Taguchi, Shunsuke Uno, Yoshifumi Uwamino, Naoki Hasegawa, Kazuaki Matsumoto

Research output: Contribution to journalArticle

Abstract

The sufficient dose to obtain an optimal trough concentration of vancomycin (VCM) in patients with non-standard physical types remains controversial. In this study, we examined the relationship between the dose and physical type in patients in whom an optimal trough concentration was obtained among VCM-treated patients. We retrospectively investigated the dose of VCM and physical type in patients treated with VCM between January 2012 and January 2017 at two medical institutions (n = 272). The physical type was classified using the body mass index (BMI). Patients with a BMI of <18.5 kg/m 2 were assigned to the lean group, those with a BMI of 18.5–24.9 kg/m 2 were assigned to the standard group, and those with a BMI of ≥25 kg/m 2 were assigned to the obesity group. The mean doses of VCM per time (mg/kg) to achieve the target trough concentration of VCM, 15–20 μg/mL, were 19.8 ± 4.3, 16.5 ± 3.7, and 13.7 ± 2.7 mg/kg in the lean, standard, and obesity groups, respectively. The dose per time to achieve the target trough concentration decreased significantly in association with an increase of BMI. The upper limit of the recommended dose (15–20 mg/kg) or higher in lean patients, and the lower dose in obese patients than the recommended dose might be appropriate to achieve the target trough concentration when we calculated the dose per time based on actual body weight.

Original languageEnglish
JournalJournal of Infection and Chemotherapy
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

Vancomycin
Body Mass Index
Obesity
Body Weight

Keywords

  • Lean
  • Obesity
  • Therapeutic drug monitoring
  • Vancomycin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Evaluation for optimal dosing of vancomycin in patients with different physical types. / Hashimoto, Mari; Iketani, Osamu; Ichinose, Naoki; Enoki, Yuki; Taguchi, Kazuaki; Uno, Shunsuke; Uwamino, Yoshifumi; Hasegawa, Naoki; Matsumoto, Kazuaki.

In: Journal of Infection and Chemotherapy, 01.01.2019.

Research output: Contribution to journalArticle

@article{ee9b39c1e3b34dd08e9747253cadc09e,
title = "Evaluation for optimal dosing of vancomycin in patients with different physical types",
abstract = "The sufficient dose to obtain an optimal trough concentration of vancomycin (VCM) in patients with non-standard physical types remains controversial. In this study, we examined the relationship between the dose and physical type in patients in whom an optimal trough concentration was obtained among VCM-treated patients. We retrospectively investigated the dose of VCM and physical type in patients treated with VCM between January 2012 and January 2017 at two medical institutions (n = 272). The physical type was classified using the body mass index (BMI). Patients with a BMI of <18.5 kg/m 2 were assigned to the lean group, those with a BMI of 18.5–24.9 kg/m 2 were assigned to the standard group, and those with a BMI of ≥25 kg/m 2 were assigned to the obesity group. The mean doses of VCM per time (mg/kg) to achieve the target trough concentration of VCM, 15–20 μg/mL, were 19.8 ± 4.3, 16.5 ± 3.7, and 13.7 ± 2.7 mg/kg in the lean, standard, and obesity groups, respectively. The dose per time to achieve the target trough concentration decreased significantly in association with an increase of BMI. The upper limit of the recommended dose (15–20 mg/kg) or higher in lean patients, and the lower dose in obese patients than the recommended dose might be appropriate to achieve the target trough concentration when we calculated the dose per time based on actual body weight.",
keywords = "Lean, Obesity, Therapeutic drug monitoring, Vancomycin",
author = "Mari Hashimoto and Osamu Iketani and Naoki Ichinose and Yuki Enoki and Kazuaki Taguchi and Shunsuke Uno and Yoshifumi Uwamino and Naoki Hasegawa and Kazuaki Matsumoto",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jiac.2019.04.017",
language = "English",
journal = "Journal of Infection and Chemotherapy",
issn = "1341-321X",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Evaluation for optimal dosing of vancomycin in patients with different physical types

AU - Hashimoto, Mari

AU - Iketani, Osamu

AU - Ichinose, Naoki

AU - Enoki, Yuki

AU - Taguchi, Kazuaki

AU - Uno, Shunsuke

AU - Uwamino, Yoshifumi

AU - Hasegawa, Naoki

AU - Matsumoto, Kazuaki

PY - 2019/1/1

Y1 - 2019/1/1

N2 - The sufficient dose to obtain an optimal trough concentration of vancomycin (VCM) in patients with non-standard physical types remains controversial. In this study, we examined the relationship between the dose and physical type in patients in whom an optimal trough concentration was obtained among VCM-treated patients. We retrospectively investigated the dose of VCM and physical type in patients treated with VCM between January 2012 and January 2017 at two medical institutions (n = 272). The physical type was classified using the body mass index (BMI). Patients with a BMI of <18.5 kg/m 2 were assigned to the lean group, those with a BMI of 18.5–24.9 kg/m 2 were assigned to the standard group, and those with a BMI of ≥25 kg/m 2 were assigned to the obesity group. The mean doses of VCM per time (mg/kg) to achieve the target trough concentration of VCM, 15–20 μg/mL, were 19.8 ± 4.3, 16.5 ± 3.7, and 13.7 ± 2.7 mg/kg in the lean, standard, and obesity groups, respectively. The dose per time to achieve the target trough concentration decreased significantly in association with an increase of BMI. The upper limit of the recommended dose (15–20 mg/kg) or higher in lean patients, and the lower dose in obese patients than the recommended dose might be appropriate to achieve the target trough concentration when we calculated the dose per time based on actual body weight.

AB - The sufficient dose to obtain an optimal trough concentration of vancomycin (VCM) in patients with non-standard physical types remains controversial. In this study, we examined the relationship between the dose and physical type in patients in whom an optimal trough concentration was obtained among VCM-treated patients. We retrospectively investigated the dose of VCM and physical type in patients treated with VCM between January 2012 and January 2017 at two medical institutions (n = 272). The physical type was classified using the body mass index (BMI). Patients with a BMI of <18.5 kg/m 2 were assigned to the lean group, those with a BMI of 18.5–24.9 kg/m 2 were assigned to the standard group, and those with a BMI of ≥25 kg/m 2 were assigned to the obesity group. The mean doses of VCM per time (mg/kg) to achieve the target trough concentration of VCM, 15–20 μg/mL, were 19.8 ± 4.3, 16.5 ± 3.7, and 13.7 ± 2.7 mg/kg in the lean, standard, and obesity groups, respectively. The dose per time to achieve the target trough concentration decreased significantly in association with an increase of BMI. The upper limit of the recommended dose (15–20 mg/kg) or higher in lean patients, and the lower dose in obese patients than the recommended dose might be appropriate to achieve the target trough concentration when we calculated the dose per time based on actual body weight.

KW - Lean

KW - Obesity

KW - Therapeutic drug monitoring

KW - Vancomycin

UR - http://www.scopus.com/inward/record.url?scp=85065832493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065832493&partnerID=8YFLogxK

U2 - 10.1016/j.jiac.2019.04.017

DO - 10.1016/j.jiac.2019.04.017

M3 - Article

C2 - 31126752

AN - SCOPUS:85065832493

JO - Journal of Infection and Chemotherapy

JF - Journal of Infection and Chemotherapy

SN - 1341-321X

ER -